Collections Specialist
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Job Description
Collections Specialist managing unpaid claims with a focus on timely adjudication and payer communications. Responsibilities include ensuring compliance with third-party regulations and optimizing accounts receivable workflow.
Responsibilities:
- Research unpaid claims, determine denial root cause, and perform appropriate follow up actions to ensure timely claim adjudication.
- Identify and take appropriate action for the billing of secondary or tertiary insurances.
- Keeps informed on all current applicable third-party payer regulations and requirements.
- Communicates payer trends and patterns to management.
- Document within a patient’s record all actions taken related account resolution.
- Review, comprehend and execute payer logic within negotiated contracts.
- Prioritize workflow to reduce or eliminate bad debt flow resulting in a reduction in days in AR.
- Meet and maintain productivity and audit standards.
- Other duties as assigned by management.
Requirements:
- High School Diploma or equivalent.
- 2-3 years of medical collections experience preferred.
- Results oriented & thrives in a fast-paced, high-energy environment.
- Ability to develop and maintain good communication and establish positive working relationships with payers, peers, and leadership.
- Strong written and verbal communication skills.
- Knowledge of medical terminology, CPT and HCPCs.
- Proficient in analyzing claims to ensure reimbursement aligns with contractual obligations.
- Ability to organize work and manage change.
Benefits:
- Comprehensive health, dental, and vision insurance
- Health Savings Account with an employer contribution
- Life Insurance
- PTO
- 401(k) retirement plan with a company match
- And more!
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